Greater Daytona Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

GREATER DAYTONA PHYSICAL THERAPY

Practice address

1901 Mason Ave Ste 105
Daytona Beach, FL 32117-5105

Phone

(386) 238-9074

Fax

(386) 238-9075

NPI assigned

Jun 18, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Ann Van Herck, PTNPI 1316492135

Title

MGR

Phone

(386) 238-9074

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ann Van Herck, P.T.

  • Physical Therapist
  • Daytona Beach, FL
  • NPI 1316492135
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1922841840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 MASON AVE STE 105",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175105",
            "telephone_number": "386-238-9074",
            "fax_number": "386-238-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MASON AVE STE 105",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175105",
            "telephone_number": "386-238-9074",
            "fax_number": "386-238-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER DAYTONA PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "VAN HERCK",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "386-238-9074",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ekaterina Grant, APRN
• Crystal Ann Gray
• Lauren Gray
• Jasmine Grays, DPT
• Tammy Diane Grayson, PA-C
• Greater Daytona Women'S Health and Physical Therapy
• Andrew B Green, DPM
• Angel A Green
• Jason A Green, CRNA, MSN
• Thomas J Green, MD

• Physical Therapist in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.